Molyneaux Insurance
  • The Molyneaux Way
    • Trumps and Tricks Euchre Event
    • ClearPath™
    • Our Team
    • Privacy Policy
  • Business
    • Employee Benefits >
      • Education and Compliance
      • Share to Compare
    • Risk Management
    • Claims Management
  • Industries
    • Franchises and Associations
  • Personal
  • Contact Us
  • Careers
    • Open Positions
  • Blog
  • The Molyneaux Way
    • Trumps and Tricks Euchre Event
    • ClearPath™
    • Our Team
    • Privacy Policy
  • Business
    • Employee Benefits >
      • Education and Compliance
      • Share to Compare
    • Risk Management
    • Claims Management
  • Industries
    • Franchises and Associations
  • Personal
  • Contact Us
  • Careers
    • Open Positions
  • Blog

​Molyneaux ​Blog

Changes for 2021 Summary of Benefits and Coverage

2/17/2021

 
health plan sbc
There are new Summary of Benefits and Coverage notice requirements for health plans starting with the 2021 coverage year.
The requirements, released by the Department of Labor, have new model templates, new instructions and new information that affects the coverage examples that are required to be in SBC documents that employers with group health plans must distribute to their employees.

Under the Affordable Care Act, all non-grandfathered health plans are required to provide enrollees and prospective applicants an SBC, which is essentially a synopsis of the plan's coverage and benefits. It must be produced in a specific format, contain specific information, and be written in a way that is easily understood.

Here are the changes that were made to the SBC template for plans that started on or after January 1:

Coverage example
The coverage examples that appear on the last page of the document have been modified to reflect changes in the cost of medical services that occur over time due to inflation and other factors:
  • "Managing Joe's Type 2 diabetes" (diabetes example): The total amount of expenses incurred for "Joe" has decreased.
  • "Mia's simple fracture" (fracture example): The total amount of expenses incurred by "Mia," who visited the emergency room for a simple fracture, has increased.
  • "Peg is having a baby" (maternity example): The costs incurred during "Peg's" hospital stay have been changed to remove separate newborn charges. The deductible line of the example should now match "your deductible amount" (if applicable).
 
Minimum essential coverage
Under the entry for minimum essential coverage, the template has been revised to reflect the elimination of the individual mandate penalty, which was repealed effective January 1, 2019.
​
The entry now indicates that individuals eligible for certain types of minimum essential coverage may not be eligible for a premium tax credit under the ACA marketplace.
 
Uniform glossary
The uniform glossary has been updated to remove references to the individual mandate penalty.
 
What to do
If you offer group health plans to your employees, you are a plan sponsor and thus required to distribute SBCs to staff who are eligible for coverage during open enrollment. The SBC must also be given to new hires within 90 days of hiring for mid-year enrollment. 
​
If you don't have your latest SBC, you can contact us or your health insurer. The insurer is obligated to provide all covered employers with updated SBCs after the Department of Labor and the Department of Health and Human Services release changes to templates.

Comments are closed.

    Categories

    All
    COVID 19
    Cyber Security
    Directors And Officers
    Employee Benefits
    News
    Personal Insurance
    Property And Casualty
    Risk Management
    Trumps & Tricks
    Wellness
    Workers Compensation

    Archives

    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    November 2017
    September 2017

Company

About Us
Our Team
​Trumps & Tricks
Testimonials
Careers
​News
Privacy Policy

Services

​Commercial Insurance
Risk Management
Employee Benefits
Group Health Insurance

Retirement Benefits
​Personal Insurance

Industry Specialization

Contact Molyneaux

​​5025 Utica Ridge Road
Suite 100
Davenport, IA 52807
​101 East Main Street
​
Suite 202
Galesburg, IL 61401
Phone: 563-324-1011 
Toll Free: 800-713-6930

Partner Agencies

LMC Insurance & Risk Management Logo
Independent Insurance Services Logo
Molyneaux Logo
The Friedman Group Logo
© COPYRIGHT 2021 Molyneaux Insurance